Treatment of Sleep Apnea & Impaired Oral Functions

By Arthur M. Strauss, DDS

A new generation of Oral Appliance Therapy, referred to as Oral Systemic Balance, addresses the impaired oral functions of speaking, swallowing and “breathing” both when awake and when asleep. Here, more sophisticated appliance designs and customization appear to have a greater and more far reaching impact upon ones breathing, sleep, ability to relax, and their entire physical, mental, emotional and spiritual well-being.

Obstructive Sleep Apnea

Obstructive sleep apnea, usually characterized by severe snoring, is now recognized as a life threatening disorder associated with higher rates of stroke, heart attack, and accidents that are often caused by excessive sleepiness while driving a motor vehicle. It also affects mental acuity, alertness and temperament leading to work impairment and social strife. Yet obstructive sleep apnea is often not diagnosed and, even when diagnosed, is often untreated or ineffectively or inappropriately treated.

Prevalence

It is estimated that more than 12 million Americans have obstructive sleep apnea. Sleep apnea is more common in men than women. One out of 25 middle-aged men and one out of 50 middle-aged women have sleep apnea. Impaired breathing and the incidence of obstructive sleep apnea increase with age.

CPAP

Although nasal continuous positive air pressure (CPAP), reputed to be the most effective method, is commonly the first approach to treatment of obstructive sleep apnea, it is poorly tolerated by about 30% of most patients during their initial trial. In addition, during the first three years of CPAP use, about 30% of the initial 70% of patients who began treatment with CPAP abandon it. Over 50% of sleep apnea patients cannot use nasal CPAP. Most find it intolerable, some find it inconvenient, and a few find it inadequate.

Oral Appliance Therapy for Obstructive Sleep Apnea

Oral appliance therapy (OAT), when appropriately practiced, provides a more predictable success rate than surgery, is reversible and considered more user-friendly than nasal CPAP.

The challenge of oral appliance therapy in the treatment of obstructive sleep apnea and in eliminating or significantly reducing snoring is dependent upon how it is practiced. Success depends on matching the most appropriate appliance, its fit, setting and method of use to the individual patient whose temperament, treatment goals, apnea characteristics, physical structures of their mouth, jaws and throat are unique to them.

Oral Systemic Balance

The new generation of oral appliance therapy, Oral Systemic Balance (OSB) Therapeutic Systems, developed by Farand C. Robson, DDS. OSB focuses on restoration of impaired oral function which primarily impacts speaking, swallowing and breathing. The observed results of OSB appear to have more profound and far-reaching effects than traditional OAT that is limited to and in the treatment of “obstructive” sleep disordered breathing. Even here OSB appears to surpass traditional OAT.